Liberty Speech Pathology Center, LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

LIBERTY SPEECH PATHOLOGY CENTER, LLC

Practice address

505 W Highway 25 70
Dandridge, TN 37725-6126

Phone

(865) 397-2892

NPI assigned

Oct 29, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Svetlana Kirk, CCC-SLP

Title

Speech-Language Pathologist

Phone

(865) 397-2892

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1383004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394496000000",
    "number": "1710315833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 W HIGHWAY 25 70",
            "city": "DANDRIDGE",
            "state": "TN",
            "postal_code": "377256126",
            "telephone_number": "865-397-2892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 W HIGHWAY 25 70",
            "city": "DANDRIDGE",
            "state": "TN",
            "postal_code": "377256126",
            "telephone_number": "865-397-2892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY SPEECH PATHOLOGY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-29",
        "last_updated": "2014-03-11",
        "status": "A",
        "authorized_official_last_name": "KIRK",
        "authorized_official_first_name": "SVETLANA",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "865-397-2892",
        "authorized_official_credential": "CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.